Dec 7 Aetna Inc on Friday said it agreed
to pay as much as $120 million to settle litigation over its
practices on the payment of claims for services by providers
with which Aetna does not have a contract.
The agreement calls for Aetna to pay $60 million, plus as
much as $60 million more following a claims submission period
that will begin after a court grants final approval to the
According to a court filing, the plaintiffs said Aetna
improperly used third-party databases to systematically underpay
claims involving services and supplies provided to members by
out-of-network providers. The litigation also challenged other
methods by which Aetna calculated out-of-network reimbursement
rates, and its disclosures for how it calculated those rates.